CRITICAL THINKING IN

NURSING

Presented by-
Ms. Neha Barari
Assistant Professor
SNSR
 Definition
Critical thinking is an active, organized, cognitive process used
to carefully examine one’s thinking and the thinking of others.

It is based on principles of science & the

scientific method & develops strategies that
maximize human potential & compensates
for problems caused by human nature.
 Why do we need to think critically?

• Need to make accurate and appropriate clinical decisions

• Need to solve problems and find solutions
• Need to plan care for each unique client and client
problem
• Need to seek knowledge and use it to make clinical
decisions and problem solving
• Need to be able to think creatively when planning care for
clients
 ASPECTS OF CRITICAL
THINKING

To develop into an expert critical thinker the nurse

needs to use:

• Reflection
• Language
• Intuition
REFLECTION-Purposely thinking
back or recalling a situation to
discover its purpose or meaning.
• Looking back and reflecting on a client
situation helps the nurse to have insight
and meaning in the situation.
• Reflection allows the nurse to look at a
situation honestly and do some self
evaluation of the situation.
• Language- The ability to use language and
express yourself is a reflection of the ability
to think meaningfully. Nurses must be able
to use language effectively (clearly and
precisely).
• When language is not well developed and
the spoken word is not clear and distinct it is
a sign of sloppy thinking.
• We must communicate (speak) clearly and
distinctly with all of those around us,
peers, nurses, patients and families. To
critically think you must be able to
organize and focus your own thoughts.
 INTUITION- To have an understanding of the
particulars in a situation without conscious deliberation.
It is an inner sensing about a situation.

• This ability to have intuition about clients come with time

and experience. Can not use only intuition must use all
types of knowledge, cognitive and emotional cues to assess
clients and seek more info. Nurses also need to be aware
of what they do not know, and seek help appropriately
Levels of Critical Thinking

Basic Critical
Thinking

Complex
Commitment Critical
Thinking
 • BASIC CRITICAL THINKING-
Here learner is still trusting that the experts have the answer
to every problem and situation

• Thinking is concrete and based on book, principles, rules,

policies (whatever they can read or hear about). Lots of
following the step by step (doing bed bath).
• At this point there is very limited ability to think critically,
resources include instructors, books, other nurses.

• Caution- Don’t let relying on resources limit ability to grow,

use experiences, practice, and knowledge to grow to next
level of thinking.
• COMPLEX CRITICAL THINKING

As people grow and become more independent thinkers the

level of critical thinking will grow. Slowly will rely less and less
on their resource people and think before asking them, come up
with the answers themselves.
• As growth occurs there is a realization that there can be more
than one alternative and perhaps solution.
• As nurses begin to think in more complex ways they look
at a problem from many more angles and start weighing the
risks vs benefits of each decision/ solution. They start
developing the ability to be creative, to think out of the box.
• COMMITMENT-
The nurse starts anticipating patient needs independently. At
this level, the nurse makes a decision based on alternatives
and then stands by the decision. The nurse assumes
accountability/ responsibility for the decision and evaluates
that decision.
 CRITICAL THINKING COMPETENCIES

General critical thinking competencies used by many

disciplines, in many everyday situations.

Scientific
method

Problem
solving

Decision
making
• SCIENTIFIC METHOD
is an approach to seeking truth or verifying facts. SM is a
formal way to approach a problem plan a solution, test the
solution, and come to a conclusion. Science fair. Nurse
might identify a problem and seek answers with a formal
approach (collecting data, formulating a hypothesis, testing
the hypothesis, evaluating the results.
• PROBLEM SOLVING-
Use problem solving all the time- when problem is
identified we seek information about the problem and the
information plus knowledge that we already have to find
solutions. Effective problem solving means evaluating the
solutions and deciding if we need to try other solutions
 • DECISION MAKING-
This happens when there are several options or courses
of action that one might take to solve a problem or take care
of a situation.
• Decision making is an end point of critical thinking. The
risks/benefits of each option is weighed to make a final decision.
If time is taken to weigh each option appropriately then a well
informed decision will be the result
 CRITICAL THINKING COMPETENCIES

Specific critical thinking in clinical situations used by

physicians, nurses, and other health care professionals.

Diagnostic reasoning/
Clinical decision making
Clinical inference
• Diagnostic reasoning- It is a process of determining a client’s
health status after gathering data and making a clinical
judgment. Part of the process involves making inferences
given data such as s/s, lab data, behaviors (Inference is the
process of drawing conclusions given related pieces of
information or data)
• Clinical decision making- requires careful reasoning so that
the options for the best client outcomes are chosen on the basis
of the client’s condition and the priority of the problem. Nurse
identifies a problem by working with client and then still
working with client determines priorities and nursing
interventions that will best meet goals of client.
• The nurse may need to select from a wide range of options to
meet goals. Clinical decision making can be made for
individual patients or groups of patients.
 CRITICAL THINKING COMPETENCIES
IN NURSING PRACTICE
• Specific critical thinking competency used in Nursing
Process
– Assessment
– Nursing Diagnosis
– Planning
– Implementation
– Evaluation
 CRITICAL THINKING MODEL
• The model helps to explain how nurses make clinical
judgments/ decisions in their clinical practice that result
in safe, effective, nursing care. There are 5 components
in this model of critical thinking:
Knowledge base
Experience in nursing
Critical thinking competencies
Attitudes for critical thinking
Standards for critical thinking
 CRITICAL THINKING ATTITUDES
• Confidence
• Thinking independently
• Fairness
• Responsibility and accountability
• Risk taking
• Discipline
• Creativity
• Curiosity
• Integrity
• Humility